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-cell
to sense and respond to glucose
1 Clinical Research Unit for Gastrointestinal Endocrinology, Department of Internal Medicine, Philipps University, 35033 Marburg, Germany; 2 Novo Nordisk, 2880 Bagsvaerd, Denmark; and 3 Department of Gastroenterology, Ludwig-Maximilians University, 81377 Munich, Germany.
Impaired glucose tolerance (IGT) and
non-insulin-dependent diabetes mellitus (NIDDM) are associated with an
impaired ability of the 
-cell to sense and respond to small changes
in plasma glucose. The aim of this study was to establish whether acute hyperglycemia per se plays a role in inducing this defect in -cell response. Seven healthy volunteers with no family history of NIDDM were
studied on two occasions during a 12-h oscillatory glucose infusion
with a periodicity of 144 min. Once, low-dose glucose was infused at a
mean rate of 6 mg · kg
1 · min1 and
amplitude 33% above and below the mean rate, and, once, high-dose glucose was infused at 12 mg · kg1 · min1 and
amplitude 16% above and below the mean rate. Mean glucose levels were
significantly higher during the high-dose compared with the low-dose
glucose infusion [9.5 ± 0.8 vs. 6.8 ± 0.2 mM (P < 0.01)], resulting in increased mean insulin
secretion rates [ISRs; 469.1 ± 43.8 vs. 268.4 ± 29 pmol/min (P < 0.001)] and mean insulin levels
[213.6 ± 46 vs. 67.9 ± 10.9 pmol/l (P < 0.008)]. Spectral analysis evaluates the regularity of oscillations in glucose, insulin secretion, and insulin at a predetermined frequency. Spectral power for glucose, ISR, and insulin was reduced during the
high-dose glucose infusion [11.8 ± 1.4 to 7.0 ± 1.6 (P < 0.02), 7.6 ± 1.5 to 3.2 ± 0.5 (P < 0.04), and 10.5 ± 1.6 to 4.6 ± 0.7 (P < 0.01), respectively]. In conclusion, short-term
infusion of high-dose glucose to obtain glucose levels similar to those previously seen in IGT subjects results in reduced spectral power for
glucose, ISR, and insulin. The reduction in spectral power previously
observed for ISR in IGT or NIDDM subjects may be due partly to hyperglycemia.
insulin secretion; connecting peptide; oscillations; spectral power
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